Nearlyin 7 COVID patients in ICU experienced severe bleeding when
given full-dose blood thinners, study finds
Research finds smaller dose of blood thinners is equally effective for
blood clots and carries less bleeding risk
Date:
January 28, 2022
Source:
University at Buffalo
Summary:
Patients with COVID-19 in the intensive care unit (ICU) prescribed
full- dose blood thinners are significantly more likely to
experience heavy bleeding than patients prescribed a smaller yet
equally effective dose, according to a recent study.
FULL STORY ========================================================================== Patients with COVID-19 in the intensive care unit (ICU) prescribed
full-dose blood thinners are significantly more likely to experience heavy bleeding than patients prescribed a smaller yet equally effective dose, according to a recent University at Buffalo-led study.
==========================================================================
The research, which compared the safety and effectiveness of blood
clot treatment strategies for more than 150 critically ill COVID-19
patients at two hospitals, found that almost all patients who experienced significant bleeding were mechanically ventilated and receiving full-dose anticoagulants (blood thinners).
The results, published last month in Hospital Pharmacy, may inform
treatment guidelines for blood clots in hospitalized COVID-19
patients, who are at an increased risk for both blood clots and severe bleeding. Previous reports have found that 17% of hospitalized COVID-19 patients experience blood clots, says first author Maya Chilbert,
PharmD, clinical assistant professor in the UB School of Pharmacy and Pharmaceutical Sciences.
"A wide variety of practice exists when it comes to approaching blood
clots in hospitalized patients with COVID-19, and there is little data
to suggest improved outcomes using one strategy versus another," says
Chilbert. "Caution should be used in mechanically ventilated patients
with COVID-19 when selecting a regimen to treat blood clots, and the
decision to use full-dose blood thinners should be based on a compelling indication rather than lab markers alone." Additional investigators in
the UB School of Pharmacy and Pharmaceutical Sciences include Collin
Clark, PharmD, clinical assistant professor, and Ashley Woodruff,
PharmD, clinical associate professor. The research was also conducted
by investigators at the Buffalo General Medical Center, Millard Fillmore Suburban Hospital and Erie County Medical Center.
The study analyzed the outcome of blood clot treatments and the rate of bleeding events for more than 150 patients with COVID-19 who received
either of two blood thinner regimens: a full-dose based on patient levels
of D-dimer (a protein present in the blood after a blood clot dissolves),
and the other a smaller but higher-than-standard dosage.
The average patient age was 58, and all experienced elevated levels of
D-dimer, fibrinogen (a protein that helps the body form blood clots),
and prothrombin time (a test that measures the time it takes for blood
plasma to clot).
Nearly 14% of patients who received full-dose blood thinners experienced a significant bleeding event, compared to only 3% of patients who received
a higher-than-standard dosage. All patients who experienced bleeding
events were mechanically ventilated. No difference was reported in the regimens' effectiveness at treating blood clots.
Further investigation is needed to determine the optimal strategy for
treating blood clots and bleeding in hospitalized COVID-19 patients,
says Chilbert.
========================================================================== Story Source: Materials provided by University_at_Buffalo. Original
written by Marcene Robinson. Note: Content may be edited for style
and length.
========================================================================== Journal Reference:
1. Maya R. Chilbert, Collin M. Clark, Ashley E. Woodruff, Kimberly
Zammit,
Cynthia Lackie, Kristen Kusmierski, Patrick McGrath, Gregory
Fuhrer, Anna Augostini, Olivia Denny, Nicole Ross, Marissa Saber,
Natalie DelGuidice.
Comparison of Higher-Than-Standard to D-Dimer Driven
Thromboprophylaxis in Hospitalized Patients With COVID-19. Hospital
Pharmacy, 2021; 001857872110664 DOI: 10.1177/00185787211066456 ==========================================================================
Link to news story:
https://www.sciencedaily.com/releases/2022/01/220128141330.htm
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